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Biomedical subjects

W Schlick

Publications and source records attributed to W Schlick.

At least 37 records · Page 2Linked to original sources

[Etiology of chronic bronchitis].

From a synopsis of the large number of epidemiological studies of the recent 20 years it is know, that inhalation of cigarette smoke is the most important factor that generates chronic bronchitis. Other noxious agents about which there are still controversial opinions, are air pollution and occupational inhalants. Although hypersecretion of mucus is the primary symptom of chronic bronchitis, it seems to have no particular prognostic meaning. Whether severe airflow obstruction develops, apparently depends upon predisposing factors such as disturbances of humoral immunity manifested by marked hypogammaglobulinemia or a defect of mucociliary clearance. In recent time increased serum IgE-levels in mom-atopic smokers with bronchial obstructions were reported. Frequent recurrent bronchial infections alone seem to be no serious risk factor. The molecular mechanisms that lead to structural damage are clarified. Activated alveolar macrophages attract polymorphonuclear leucocytes by chemotaxis. These cells set free proteolytic enzymes such as elastases. In addition certain oxidants inhibit the protection system of proteinase inhibitors.

Air Pollution↗

Effects of prednisolone on beta-adrenergic desensitization of normal peripheral lymphocytes: an in vitro model for steroid-controlled tachyphylaxis.

In vitro culture of human peripheral blood lymphocytes with the beta-adrenergic catecholamine isoproterenol for 24 hours, induced homologous beta-adrenergic desensitization, i.e. a large decrease in the number of beta-adrenergic binding sites and loss of the adenylate cyclase response to isoproterenol, without altering the effectiveness of prostaglandin E1 to stimulate the enzyme. Lymphocyte cultures pulsed for 24 hours with isoproterenol, washed free of the agent and cultured in hormone-free medium for 48 hours still showed marked suppression of the beta-adrenergic adenylate cyclase response and a lack of beta-receptors. When prednisolone was added to the isoproterenol-depleted resuspension medium of desensitized lymphocytes, however, the beta-adrenergic system recovered fully within 48 hours. Treatment of desensitized lymphocytes with prednisolone in the continuous presence of isoproterenol failed to restore beta-adrenergic responsiveness of the cells. The results are discussed with respect to the reconstituting effect of prednisolone on beta-adrenergic responsiveness in bronchial asthma after therapy induced tachyphylaxis.

Adenylyl Cyclases↗

[Neurophysiologic studies in Pickwickian syndrome].

In 11 patients clinically diagnosed as Pickwickian syndrome the results of daytime and night polysomnogramm were compared. The daytime recording was very efficient in identifying apnoea and correlating various types of apnoea to different sleep stages. In polysomnogramms of night sleep we found, as did Lugaresi, a reduction of sleep stages III and IV, and a slight increase of sleep stages I and II. Patients without apnea in daytime sleep also showed a normal apnea index in night sleep. The BAEP's especially the pontomesencephalic components were pathological in six patients (55%). This might be due to a primary lesion or to hypoxic damage of the brainstem.

Adult↗

Acute effects of pirenzepin on bronchospasm.

The response to pirenzepin, a new acetylcholine receptor blocking agent, was assessed and compared to placebo in patients with reversible bronchoconstriction. A single intravenous injection of 20 mg of pirenzepin induced a significant reduction of airway resistance compared to placebo (p less than 0.05). The anticholinergic substance pirenzepin appears to be useful in the treatment of bronchospasm.

Aged↗

[Control of spontaneous respiration with continuous positive airway pressure using transthoracic electrical impedance. Studies in subjects with healthy lungs].

A clinically practicable method for the control of intrapulmonary gas volume changes for patients with spontaneous respiration and CPAP has been evaluated. Changes of intrapulmonary gas volume caused by different continuous positive air-way pressures (CPAP) can be monitored sufficiently using a noninvasive technique of transthoracic electrical impedance (Z0). In 24 healthy volunteers Z0 (rheography) was measured. After stepwise increase of CPAP from 5-20 cm H2O a significant increase of Z0 could be observed. Z0 pressure relations, detected by regression analysis showed a correspondence of intrapulmonary gas filling changes and volume/pressure relation. We therefore conclude that the control of Z0 pressure relationship for the calculation of the maximum is of some importance for determination of therapeutic levels of CPAP.

Adult↗

[Intralobar pulmonary sequestration].

14 cases of intralobar sequestration of the lung are reviewed. There are 3 different patterns of clinical and radiological symptoms. Angiography is of great value in establishing the diagnosis and defining the anatomic details of the anomalous blood supply, allowing careful planning of the surgical procedure, which was a lower lobectomy in 12 cases. Segmental resections were feasible in 2 cases. No significant complications were observed.

Adolescent↗

[Long-term survival after pulmonary resection in bronchogenic carcinoma (author's transl)].

25 patients with bronchogenic carcinoma, who had undergone pulmonary resection between 1950 and 1964, were re-examined after a survival time of between 15 and 29 years. There was no relation between the long survival time and the duration of preoperative symptoms, the smoking habits prior to the operation or the localization of the tumour. The histological classification revealed that 14 patients had suffered from squamous cell carcinoma and 11 from large cell carcinoma. There was no case of adenocarcinoma nor of small cell carcinoma. In 7 patients tumour cells were demonstrable in the resected lymph nodes and in at least 2 cases the edge of the resected tissue was not tumour-free. In one case the blood vessels were invaded by tumour cells.

Adenocarcinoma↗

[Home-respirator treatment in idiopathic hypoventilation (author's transl)].

A report is given on a 66 years old patient with severe idiopathic hypoventilation. Two years ago the disease had developed rather suddenly with severe hypoventilation during sleep, accompanied by marked hypoxemia and hypercapnia with pCO2-values above 100mm Hg and respiratory acidosis. No pulmonary, cardiac or neurological disease was found. After failure of two attempts of stimulation of the phrenic nerve the patient was admitted to a respiratory intensive care unit and ventilated by a respirator during sleep. After improvement of this general condition he was discharged at first only in the daytime, later he could be discharged fully from the unit, after a respirator had been installed in his home. Now the patient is connecting himself to the respirator during sleep and since 20 months is so in a tolerable condition. The indications for home-respirator treatment are discussed.

Aged↗

[3-years' domiciliary respirator therapy in idiopathic hypoventilation syndrome (ondine's curse syndrome) (author's transl)].

A 67 years old patient with a tracheostomy and cribral cannula on account of severe idiopathic hypoventilation syndrome was discharged from the intensive care unit having been supplied with a respirator (MK 8-Bird) and compressor by his health insurance. The domiciliary respirator therapy was continued for more than 3 years. The disorder manifested itself initially in severe hypoventilation during sleep, acute hypoxaemia, hypercapnia and respiratory acidosis. The patient himself and his family took on the adjustment and maintenance of the respirator, having being appropriately trained before his discharge from hospital. The treatment succeeded for over 3 years in maintaining an acceptable quality of life for the patient.

Aged↗

[Long-term treatment of bronchial asthma with disodiumcromoglycate (Intal) (author's transl)].

26 patients with chronic perennial bronchial asthma were treated with disodiumcromoglycate (Intal). The drug was administered by spinhaler in a daily dose of 4 capsules à 20 mg. There was significant clinical improvement within the first three months of treatment. Airway resistance showed a statistically significant decrease after three months of DSCG treatment. 15 of the 26 patients had been on long-term steroid treatment, in 9 of these 15 patients steroid therapy could be discontinued completely. It is stated that DSCG is effective also in nonallergic bronchial asthma, that there is not only significant clinical improvement, but also functional improvement after three months of DSCG, and that in some steroid dependent asthmatics reduction or complete withdrawal of steroid therapy can be achieved.

Airway Resistance↗

[Late results of tracheal resection (author's transl)].

17 cases of tracheal stenosis following prolonged endotracheal intubation are reported. Resection of the stenotic segment and anastomosis were performed in all patients. The clinical result was classified as good in 15 patients and as satisfactory in one patient. One patient died from wound dehiscence and mediastinitis. Results of pre- and postoperative respiratory function tests are presented and the validity of these tests for objective evaluation of operative results is discussed. Diagnostically most informative is the quantitative and qualitative evaluation of airway resistance and MEFV curves.

Adolescent↗

[Influence of centrophenoxin administered for one year in high dose on maximal oxygen consumption in aged persons (author's transl)].

The influence of centrophenoxin (meclofenoxate) administration in a high daily dosage of 3 grams has been investigated in 10 persons with a mean age of 64 throughout 12 months. The mean age of the control group was 59. The function of bone marrow and a number of indicators of renal and hepatic function has shown no harmful changes after this long term treatment with an extremely high daily dosage. To investigate a possible influence on aging we chose the oral glucose tolerance test, a test battery for pulmonary function and the maximum oxygen consumption capacity. A highly significant (2P smaller than 0,335) influence of the drug for increasing the maximum oxygen input has been found. The hypothesis is presented, that this effect is due to an increase in cardiac functional capacity. Furthermore a significant decrease in fasting glucose levels has been found, while the glucose concentration one and two hours after administration of 100 grams of oral glucose have shown no significant changes. Body weight revealed a small but significant decrease. Side effects: we found a mild gastric pain in 4 patients that disappeared after 20 minutes. 5 Patients complained of a very small increase in jitteriness.

Aged↗

Specific weight loss in hyperthyroidism.

To assess metabolic turnover in patients with hyperthyroidism weight loss in mg . kg-1 . min-1 (specific weight loss, SWL) was measured by means of a new type of scale working on the buoyance principle with a minimal susceptibility of 10 mg per 100 kg. Weight loss rate was significantly increased in hyperthyroid patients (n=22;SWL, 22.0 +/-1.4 (SE) mg. kg-1 . min-1) compared to health controls (n=11; SWL, 10.0 +/-0.4 (SE) mg . kg-1 . min-1). The fall in SWL paralleled the decrease in thyroid hormone levels in serum in the beginning of antithyroid treatment and remained unchanged thereafter in spite of a further drop in thyroxine (T4) and triiodothyronine (T3) levels. After six weeks of treatment SWL reached the upper normal range despite hormone levels in the low range of normal. The findings indicate that the normalization of the basal metabolic rate as assessed by the estimation of SWL is slower than the decline in serum hormone levels. There was no correlation between thyroid hormone levels and SWL before initiating therapy or during antithyroid treatment (T4 vs. SWL, r = 0.22;n = 56). Thus serum levels of T4 and T3 appear to be rather insufficient indices regarding the respective metabolic state as estimated by SWL.

Adult↗

[Results of operative treatment of artial septal defect in the adult (author's transl)].

55 of 59 patients with artial septal defect, who had been operated in adult age, were examined postoperatively. The mean time interval from the operation was 43,8 months. Two patients had died immediately after the operation; there were no late deaths. The majority of the reexamined subjects was free of symptoms, in no case was there congestive heart failure. Persistence of postoperative symptoms increased with increasing age at the time of operation, but only up to the fourth decade of life. In 26 cases hemodynamics were examined. Mean pulmonary arterial pressure was normal at rest and during a slight ergometric load. In 5 patients there was moderate pulmonary hypertension. In 8 subjects there was minimal, in one patient moderate increase of pulmonary vascular resistance. Heartsize in chest roentgenogramm was increased in about 25% of cases, in more than 50% the pulmonary vessels were accentuated. Irregularities of cardiac rhythm were not more frequent postoperatively, than they had been prior to surgery. However, surgery was followed by a marked decrease of right axis deviation and of EKG signs of right ventricular hypertrophy. Pulmonary function studies revealed a slight decrease of vital capacity and of maximal breathing capacity. These results are favourable compaired to medically treated groups of patients as described in the literature. It is concluded, that even in later adult age the atrial septal defect as a rule is an indication for surgery.

Adult↗